Provider Demographics
NPI:1275831877
Name:N'DIONE, JOHNNYMAE (PHARMD)
Entity Type:Individual
Prefix:
First Name:JOHNNYMAE
Middle Name:
Last Name:N'DIONE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 SOUTHERN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:DE
Mailing Address - Zip Code:19977-4089
Mailing Address - Country:US
Mailing Address - Phone:302-653-6015
Mailing Address - Fax:302-653-6015
Practice Address - Street 1:723 N BROAD ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-1166
Practice Address - Country:US
Practice Address - Phone:302-378-8228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-05
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0003607183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist